Center for Development Research (ZEF), University of Bonn, Genscherallee 3, 53113, Bonn, Germany.
Global Health, Institute for Hygiene and Public Health (IHPH), University Hospital Bonn, 53127, Bonn, Germany.
Hum Resour Health. 2021 Jan 22;19(1):13. doi: 10.1186/s12960-021-00558-3.
Community health workers (CHWs) are the mainstay of the public health system, serving for decades in low-resource countries. Their multi-dimensional work in various health care services, including the prevention of communicable diseases and health promotion of non-communicable diseases, makes CHWs, the frontline workers in their respective communities in India. As India is heading towards the development of One Health (OH), this study attempted to provide an insight into potential OH activists (OHA) at the community level. Thus, this case study in one of India's western cities, Ahmedabad, targeted identifying OHA by exploring the feasibility and the motivation of CHWs in a local setting.
This case study explores two major CHWs, i.e., female (Accredited Social Health Activists/ASHA) health workers (FHWs) and male (multipurpose) health workers (MHWs), on their experience and motivation for becoming an OHA. The data were collected between September 2018 and August 2019 through a mixed design, i.e., quantitative data (cross-sectional structured questionnaire) followed by qualitative data (focus group discussion with a semi-structured interview guide).
The motivation of the CHWs for liaisoning as OHA was found to be low; however, the FHWs have a higher mean motivation score [40 (36-43)] as compared to MHWs [37 (35-40)] out of a maximum score of 92. Although most CHWs have received zoonoses training or contributed to zoonoses prevention campaigns, their awareness level was found to be different among male and female health workers. Comparing the female and male health workers to act as OHA, higher motivational score, multidisciplinary collaborative work experience, and way for incentive generation documented among the female health workers.
ASHAs were willing to accept the additional new liaison role of OHAs if measures like financial incentives and improved recognition are provided. Although this study documented various systemic factors at the individual, community, and health system level, which might, directly and indirectly, impact the acceptance level to act as OHA, they need to be accounted for in the policy regime.
社区卫生工作者（CHWs）是公共卫生系统的支柱，在资源匮乏的国家服务了几十年。他们在各种医疗服务中发挥着多方面的作用，包括预防传染病和促进非传染性疾病的健康，使 CHWs 成为印度各自社区的一线工作者。随着印度朝着发展“同一健康”（OH）的方向前进，本研究试图在社区层面上为潜在的 OH 活动家（OHA）提供一些见解。因此，这项在印度西部城市艾哈迈达巴德的案例研究旨在通过探索当地 CHWs 的可行性和动机，确定 OHA。
本案例研究探索了两种主要的 CHWs，即女性（认证社会卫生活动家/ASHA）卫生工作者（FHWs）和男性（多用途）卫生工作者（MHWs），了解他们成为 OHA 的经验和动机。数据于 2018 年 9 月至 2019 年 8 月通过混合设计收集，即定量数据（横断面结构化问卷），随后是定性数据（焦点小组讨论和半结构化访谈指南）。
发现 CHWs 作为 OHA 的联络动机较低；然而，FHWs 的动机得分[40（36-43）]高于 MHWs [37（35-40）]，最高得分为 92 分。尽管大多数 CHWs 都接受过动物传染病培训或参与过动物传染病预防运动，但他们的意识水平在男女卫生工作者之间存在差异。将男女卫生工作者进行比较，发现女性卫生工作者在更高的激励得分、多学科协作工作经验和激励产生方式方面更愿意担任 OHA。
如果提供财政激励和提高认可等措施，ASHA 愿意接受 OHAs 的额外新联络角色。尽管本研究记录了个人、社区和卫生系统层面的各种系统因素，这些因素可能直接或间接影响担任 OHA 的接受程度，但这些因素需要在政策制度中得到考虑。
